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General NPI Number Information
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NPI Number | 1124631767
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Entity Type | Organization
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Legal Business Name | THE ART OF WELLNESS MD
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 255 S 17TH ST STE 1608
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6216
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Country | US
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Telephone | 484-321-6977
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Fax |
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Provider Business Mailing Address
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Address Line | 255 S 17TH ST STE 1608
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6216
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Country | US
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Telephone | 484-321-6977
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Fax |
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Authorized Official
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Title or Position | OWNER, DIRECTOR
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Name | PAUL JOSEPH RESIGNATO
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Credential | MD
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Telephone | 484-321-6977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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